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HIV DNA was measured by real-time PCR in the peripheral blood mononuclear cells (PBMCs) of 22 patients observed for a median follow-up of 31.0 months.

At baseline, HIV DNA was found to be correlated with HIV-1 RNA (HIV RNA) (r = 0.56), but not with CD4(+) counts (r = -0.10).

HIV RNA load was under control for the entire follow-up, while HIV DNA levels were almost always detectable (baseline levels vs. 1 year from ASCT levels, p > 0.05).

Baseline HIV DNA levels were significantly different between alive and deceased patients (p = 0.03), and the overall survival (OS) analysis showed that for patients with higher HIV DNA levels at baseline there was a higher and nearly significant risk of death if compared to patients with lower levels (HR, 8.33, 95% CI, 0.99-70.06, p = 0.05).

Our study demonstrated that high HIV DNA levels at baseline could predict overall survival after ASCT in one of the largest cohorts of HIV lymphoma patients treated with salvage therapy.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Plasmablastic lymphoma is an aggressive neoplasm that shares many cytomorphologic and immunophenotypic features with plasmablastic plasma cell myeloma.

However, plasmablastic lymphoma is listed in the World Health Organization (WHO) classification as a variant of diffuse large B-cell lymphoma.

To characterize the relationship between plasmablastic lymphoma and plasmablastic plasma cell myeloma, we performed immunohistochemistry using a large panel of B-cell and plasma cell markers on nine cases of plasmablastic lymphoma and seven cases of plasmablastic plasma cell myeloma with and without HIV/AIDS.

All cases of plasmablastic lymphoma and plasmablastic plasma cell myeloma were positive for MUM1/IRF4, CD138, and CD38, and negative for CD20, corresponding to a plasma cell immunophenotype.

PAX-5 and BCL-6 were weakly positive in 2/9 and 1/5 plasmablastic lymphomas, and negative in all plasmablastic plasma cell myelomas.

Three markers that are often aberrantly expressed in cases of plasma cell myelomas, CD56, CD4 and CD10, were positive in 5/9, 2/5, and 6/9 plasmablastic lymphomas, and in 3/7, 1/5, and 2/7 plasmablastic plasma cell myelomas.

The only significant difference between plasmablastic lymphoma and plasma cell myeloma was the presence of EBV-encoded RNA, which was positive in all plasmablastic lymphoma cases tested and negative in all plasma cell myelomas.

In conclusion, most cases of AIDS-related plasmablastic lymphoma have an immunophenotype and tumor suppressor gene expression profile virtually identical to plasmablastic plasma cell myeloma, and unlike diffuse large B-cell lymphoma.

These results do not support the suggestion in the WHO classification that plasmablastic lymphoma is a variant of diffuse large B-cell lymphoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We report an HIV-positive patient who developed a unilateral retinitis and subsequent intracranial lesions.

The finding of Epstein Barr virus (EBV) DNA at a > 1-log greater concentration in the vitreous compared to blood raised the possibility of a primary CNS non-Hodgkin's lymphoma, which was subsequently confirmed on brain biopsy.

In the highly active antiretroviral therapy era, an increasingly large number of HIV-infected patients are developing non- AIDS-defining cancers (NADCs).

Herein, we describe a patient with AIDS who presented to medical attention with pancytopenia 48 months postchemotherapy with etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (R-EPOCH) for diffuse large B-cell lymphoma.

With the diagnosis of therapy-related acute myeloid leukemia (AML) secured, he began induction chemotherapy with idarubicin and cytarabine.

Through a literature search, we were able to identify 4 additional cases of therapy-related AML in AIDS patients following chemotherapy for lymphomas.

The median age of these patients at the time of AML diagnosis was 39 years (range, 33-59 years), the median time from the treatment of lymphoma to AML was 18 months (range, 11-48 months), and the median survival following induction chemotherapy was 4 weeks (range, 2-16 weeks).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Most of these diseases are life-threatening and the prognosis of AIDS-associatedlymphomas is extremely unfavorable.

We investigated the possibility of nuclear factor kappa B (NF-kappaB) inhibition by dehydroxymethylepoxyquinomicin (DHMEQ) for the treatment and prevention of EBV-associated lymphoproliferative diseases.

These results suggest that NF-kappaB is a molecular target for the treatment and prevention of EBV-associated lymphoproliferative diseases.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PURPOSE OF REVIEW: We discuss recently published studies that elucidate the pathogenesis of AIDS-associated lymphoma.

RECENT FINDINGS: Several recent reports have provided valuable new information on the role of gamma-herpesviruses in the pathogenesis of AIDS-associated lymphoma.

In addition to this, significant new information has become available on how B cell activation-associated DNA-modifying events, involving activation-induced cytidine deaminase and DNA polymerase-eta, contribute to the molecular lesions that result in AIDS-associated lymphoma.

In particular, new evidence that oncogenic viruses can directly induce activation-induced cytidine deaminase expression and oncogene mutation in human B cells is of central relevance to better understanding the pathogenesis of AIDS-associated lymphoma.

SUMMARY: New information provides insights into the contributions of immune dysfunction and oncogenic virus infection to pathogenesis of AIDS-associated lymphoma, and may lead to new potential targets for therapeutic intervention in these cancers.

Reduced VEGF protein expression in primary HIV-1 positive BL and DLBCL, compared to the negative cases, supported the findings of promoter downregulation from the cell lines.

Thus, targeting Tat protein itself and stabilizing transient silencing of VEGF expression or use of monoclonal antibodies against their receptors in the AIDS-associated tumors will open a window for future explorable pathways in the management of angiogenic phenotypes in the AIDS-associated non-Hodgkin's lymphomas.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Advantages of flow cytometry immunophenotyping for the diagnosis of central nervous system non-Hodgkin's lymphoma in AIDS patients.

BACKGROUND: Neurological disorders are common in HIV-infected patients.

Central nervous system (CNS) lymphoma should always be considered because it is an important cause of morbidity and mortality.

OBJECTIVES: To investigate the clinical utility of flow cytometry immunophenotyping (FCI) in diagnosing or discarding leptomeningeal involvement in HIV-infected patients and to compare its sensitivity with that of conventional cytological methods.

These last lymphomas, also called "solid PEL", have been reported before the development of an effusion lymphoma and after resolution of PEL.

Interestingly, KSHV/HHV-8 associatedlymphomas that present as solid or extracavitary based lesions in HIV seropositive patients without serous effusions have been reported recently.

METHODS/RESULTS: This paper provides evidence for the existence of a previously undescribed KSHV/HHV-8 associated lymphoma in HIV seronegative patients without serous effusions.

These lymphomas exhibit a predilection for the lymph nodes and display anaplastic large cell morphology.

B and T cell associated antigens and other commonly used lymphoid markers were absent or weakly demonstrable in a fraction of the tumour cells.

CONCLUSIONS: Analysis of viral infection and immunohistological studies are of primary importance to define this lymph node based KSHV/HHV-8 associated lymphoma with anaplastic large cell morphology and plasmablastic immunophenotype occurring in HIV seronegative patients without serous effusions.

[Language] eng

[Publication-country] England

[Chemical-registry-number] 0 / Antigens, Neoplasm

[Other-IDs] NLM/ PMC1770735

16. Ho-Yen C, Chang F, van der Walt J, Lucas S: Gastrointestinal malignancies in HIV-infected or immunosuppressed patients: pathologic features and review of the literature.Adv Anat Pathol; 2007 Nov;14(6):431-43[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Gastrointestinal malignancies in HIV-infected or immunosuppressed patients: pathologic features and review of the literature.

The gastrointestinal (GI) tract is a common internal organ to be involved by human immunodeficiency virus (HIV)-related malignancies.

It is the second most common site for Kaposi sarcoma after skin, and the commonest visceral site, for Kaposi sarcoma in AIDS patients.

GI lymphomas have been documented in approximately 25% of AIDS patients with systemic lymphomas.

Moreover, GI involvement of AIDS-lymphoma has been associated with poor prognosis and short survival.

Several other malignancies that occur in the GI tract are also closely related to HIV-infected or immunosuppressed individuals; these include posttransplant lymphoproliferative disorder, Epstein-Barr virus-associated smooth muscle tumors, anal precancerous lesions, and squamous cell carcinoma.

As a result of active antiretroviral therapy, patients infected with HIV are living longer and are consequently at increased risk for development of cancer.

Therefore, it is possible that the number of AIDS-associated malignancies will rise and the pattern of tumors may change in the future.

In this paper, the clinicopathologic features of GI malignancies associated with AIDS patients are reviewed and the differential diagnosis with other mimic lesions is discussed.

We here report a high incidence of KSHV infection in solid HIV-associated immunoblastic/plasmablastic non-Hodgkin's lymphomas (NHLs), in patients lacking effusions and without evidence of (prior) MCD.

Within a cohort of 99 HIV-related NHLs, 10 cases were found to be KSHV positive on the basis of immunostaining for KSHV LNA-1 as well as KSHV-specific polymerase chain reaction.

Interestingly, all KSHV-positive cases belonged to a distinctive subgroup of 26 diffuse large B-cell lymphomas characterized by the expression of CD138 (syndecan-1) and plasmablastic/immunoblastic morphology.

These KSHV-positive lymphomas were preceded by Kaposi sarcoma in 60% of the patients and involved the gastrointestinal tract in 80%.

Our results indicate that KSHV infection is not restricted to PEL and MCD; it is also common (38%) in HIV-related solid immunoblastic/plasmablastic lymphomas.

Western and northern blotting showed that coronin 1A was predominantly expressed in solid lymphomas.

These data demonstrate that effusion and solid lymphomas possess distinctive gene and protein expression profiles in our mouse model, and suggest that differences in gene and protein expression between effusion and solid lymphomas may be associated with the formation of effusion lymphoma or invasive features of solid lymphoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We previously described uPAR/uPA overexpression in the cerebrospinal fluid (CSF) and brain tissues of patients with human immunodeficiency virus (HIV)-related cerebral diseases.

In this study, we examined uPAR/uPA expression by immunohistochemistry (IHC) in brains of HIV patients with opportunistic cerebral lesions and in HIV-positive/negative controls. uPAR was found in macrophages/microglia with the highest levels in cytomegalovirus (CMV) encephalitis, toxoplasmosis, and lymphomas; in cryptococcosis and progressive multifocal leukoencephalopathy (PML) cases, only a few positive cells were found and no positivity was observed in controls. uPA expression was demonstrated only in a few macrophages/microglia and lymphocytes in all the cases and HIV-positive controls without different pattern of distribution; no uPA immunostaining was found in cryptococcosis and HIV-negative controls.

[Publication-type] Case Reports; Journal Article

[Publication-country] Brazil

21. Mani H, Jaffe ES: Hodgkin lymphoma: an update on its biology with new insights into classification.Clin Lymphoma Myeloma; 2009 Jun;9(3):206-16[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Hodgkin lymphoma: an update on its biology with new insights into classification.

In the past few years, there has been a greater understanding of the spectrum and biology of Hodgkin lymphoma (HL).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Simian virus 40 (SV40) is associated with some systemic non-Hodgkin's lymphomas (NHL) among HIV-positive patients, based on assays for viral DNA sequences.

To investigate the possible production of the viral transforming protein, we examined age-matched case-control specimens from patients with HIV/AIDS for the expression of SV40 large tumor antigen (T-ag).

Fifty-five systemic NHL and 25 nonmalignant lymphoid and malignant nonlymphoid tissue control cases from two HIV community programs in Texas and New Jersey were scored for IHC positivity without knowledge of the PCR results.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Non-Hodgkin lymphomas concurrent with HHV8-associated Kaposi's sarcoma in the same lymph node in AIDS and non-AIDS patients.

BACKGROUND: The association between lymphomas and Kaposi's sarcoma has been described since 1920.

METHODS: Two cases of concurrent non-Hodgkin lymphoma and Kaposi's sarcoma in the same lymph node are described: a diffuse large B cell lymphoma in an AIDS patient and a T cell-rich large B cell lymphoma in a HIV-negative patient, complete with the clinical, immunohistological and molecular features, the latter ones defined after isolation of the different neoplastic areas by laser capture microdissection.

CONCLUSION: This study represents a further confirmation of the supposed different etiopathogenic mechanisms of the 2 neoplasias, suggesting a coincidental occurrence even when localized in the same lymph node, independently from HIV infection.

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[Copyright] Copyright 2007 S. Karger AG, Basel.

(PMID = 17505129.001).

[ISSN] 1421-9662

[Journal-full-title] Acta haematologica

[ISO-abbreviation] Acta Haematol.

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Switzerland

[Chemical-registry-number] 0 / DNA, Viral

25. Epeldegui M, Vendrame E, Martínez-Maza O: HIV-associated immune dysfunction and viral infection: role in the pathogenesis of AIDS-related lymphoma.Immunol Res; 2010 Dec;48(1-3):72-83[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]HIV-associated immune dysfunction and viral infection: role in the pathogenesis of AIDS-relatedlymphoma.

HIV infection is associated with a much higher risk for the development of non-Hodgkin lymphoma (AIDS-NHL).

The principal causes of lymphomagenesis in HIV-infected individuals are thought to be the loss of immune function seen in HIV infection, which results in the loss of immunoregulation of Epstein-Barr virus-infected B cells, as well as HIV infection-associated immune dysregulation, including chronic B-cell activation.

In this review, we discuss recent reports that further support the importance of these factors, and we highlight emerging evidence of different mechanisms that potentially drive lymphomagenesis in HIV-infected individuals.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Primary mediastinal large B-cell lymphoma in HIV: report of two cases.

Primary mediastinal large B cell lymphoma (PMLBCL) is a subtype of diffuse large B cell lymphoma arising in the mediastinum with distinctive clinical and morphological features.

Though diffuse large B cell lymphoma is one of the most common non-Hodgkin lymphoma associated with AIDS, there are no data available regarding the association of HIV and PMLBCL.

We report here two cases of PMLBCL arising in AIDS patients.

One of the two patients, a 25-year-old woman who had localized disease and evidence of Epstein-Barr virus in lymphoma cells, did not respond to chemotherapy and died of disease progression 5 months after diagnosis.

The second patient, a 38-year-old male with disseminated disease, responded to therapy and is disease-free after 9 months of follow-up.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Malignant melanoma and squamous cell carcinoma are examples of cutaneous malignancies that have a more aggressive course in patients with HIV.

The incidence of HIV-associated Kapsosi's sarcoma has markedly decreased since the advent of HIV antiretroviral therapy.

Cutaneous T-cell lymphoma (CTCL) is rare in this population.

Other types of cutaneous lymphoma and HIV-associated pseudo-CTCL are discussed.

LEARNING OBJECTIVE: At the completion of this learning activity, participants should be familiar with the unique epidemiology, clinical course, and management of cutaneous malignancy in patients infected with HIV.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Advanced stage is the most important prognostic factor for survival in patients with systemic acquired immunodeficiency syndrome-related non-Hodgkin's Lymphoma treated with CHOP and highly active antiretroviral therapy.

In the era of highly active antiretroviral therapy (HAART), the prognosis for acquired immunodeficiency syndrome-related lymphomas (ARL) seems to be similar to that for aggressive B-cell lymphomas in human immunodeficiency virus (HIV)-negative patients.

We evaluated the prognostic factors for response and survival in a series of HIV-infected patients with systemic non-Hodgkin's lymphoma (NHL) in the HAART era.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: One of the major concern for high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT) for HIV-associated lymphoma is that posttransplant immunosuppression might worsen immune defects of HIV individuals.

Since the introduction of highly active antiretroviral therapy has made HSCT possible also in these patients, we analyzed whether the immune system already compromised by HIV infection might support an efficient T-cell recovery after HSCT.

METHODS: The kinetics and the extent of T-cell reconstitution were investigated before and after HSCT in four patients with HIV-relatedlymphoma (one with Hodgkin's Disease and three with non-Hodgkin's lymphoma) by measuring the thymic output, the level of IL-7 and the heterogeneity of T-cell repertoire.

CONCLUSIONS: High-dose therapy and HSCT in HIV patients under highly active antiretroviral therapy does not worsen the immune defects.

Immunochemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab (R-CHOP) is the standard treatment in non-immunosuppressed patients with diffuse large B-cell lymphoma (DLBCL), but its adequacy has not been definitively established in patients with human immunodeficiency virus (HIV)-relatedlymphoma.

This phase II trial aimed to evaluate the safety and efficacy of six cycles of R-CHOP in patients with HIV-related DLBCL and to determine whether response to highly active antiretroviral therapy (HAART) had prognostic impact.

Complete response was achieved in 55 (69%) patients, with an estimated 3-year disease-free survival of 77% and 3-year overall survival of 56%.

In HIV-related DLBCL R-CHOP is feasible, safe and effective.

The prognosis depends on lymphoma-related parameters and on the response to HAART.

OBJECTIVES: to estimate survival, after AIDS diagnosis, in people who got infected with HIV through injecting drug use (IDUs), to identify among variables collected at AIDS diagnosis those which were associated to prognosis and to assess the frequency of morbid conditions at death.

SETTING AND PARTICIPANTS: 4,040 IDUs diagnosed with AIDS in Italy between 1999 and 2005.

RESULTS: the 2-year and 5-year survival probabilities after AIDS diagnosis of IDUs were 72% and 60%, respectively.

CONCLUSION: the results of this population-based study showed that, in the highly active antiretroviral therapy era, survival of IDUs with AIDS was still lower compared to that of HIV sexual transmission groups.

The presence at death, in 52% of cases, of non AIDS-defining illnesses indicates the important role on mortality of co-morbidities, including liver diseases and violent causes.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: The established International Prognostic Index for lymphomas has not included patients with systemic AIDS-related non-Hodgkin lymphoma.

OBJECTIVE: To establish the most appropriate prognostic index for use in patients with systemic AIDS-related non-Hodgkin lymphoma.

DESIGN: A prospective study involving univariate and multivariable analyses of patients with AIDS-related non-Hodgkin lymphoma whose data were used to examine standard and new criteria for survival after diagnosis.

SETTING: The Chelsea and Westminster cohort of HIV-1-infected persons.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVES: To provide survival estimates of Italian people with AIDS (PWA) in the highly active antiretroviral therapy era and to identify prognostic factors at diagnosis and illnesses present at death.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Four cases of non-Hodgkin's lymphoma in AIDS patients.

The incidence of opportunistic infection has decreased since the introduction of highly active antiretroviral therapy, so lymphoma is now far and away the most lethal complication of acquired immunodeficiency syndrome.

We have experienced four cases of NHL in AIDS patients.

The first patient was a 37 year old male who presented with left sided hemiplegia due to CNS lymphoma.

The second patient was a 40 year old male who was admitted because of jaundice; he was diagnosed as having lymphoma that exclusively involved the liver.

The third patient was a 38-year-old male who presented with palpable mass in the left cervical region, which was diagnosed as lymphoma.

Above three cases were confirmed as diffuse large B cell lymphoma.

The latter case is the first report of NHL involving the chest wall musculature in a Korean AIDS patient.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Non-Hodgkin's lymphomas of the digestive tract and anexal glands in AIDS patients].

BACKGROUND: Non-Hodgkin's lymphoma (NHL) is the second most common neoplasm among patients with AIDS.

One of the major clinical characteristics of AIDS-associated NHL is the high frequency of extra-nodal involvement, including the gastrointestinal tract, at initial presentation.

METHODS: From January 1997 to December 2004, 8 cases of NHL of the digestive tract and anexal glands (liver and parotid gland) were observed at the HIV/AIDS division of the Infectious Diseases FJ Muñiz Hospital from Buenos Aires, Argentina.

The global incidence of AIDS-associatedlymphomas (central nervous system lymphomas, non-Hodgkin lymphomas and Hodgkin lymphoma) during the time of study was 2,9% (54 cases); 17 patients (32%) had diagnosis of systemic NHL; 10 (58,8%) of them were extranodal at the onset of clinical symptoms and 8 (80%) involvement the digestive tract and anexal glands (parotid gland, cavum, esophagus, stomach, duodenum, the right colon in 2 patients and the liver), as primary NHL of high grade and "B" phenotype.

Primary duodenal lymphoma was the only Burkitt lymphoma of this serie and we detected the Epstein-Barr virus genome in the biopsy smears of this tumor and in the hepatic lymphoma.

CONCLUSION: NHL of the gastrointestinal tract is a severe complication of advanced HIV/AIDSdisease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: There is currently no effective AIDS vaccine, emphasizing the importance of developing alternative therapies.

Recently, a patient was successfully transplanted with allogeneic, naturally resistant CCR5-negative (CCR5Delta32) cells, setting the stage for transplantation of naturally resistant, or genetically modified stem cells as a viable therapy for AIDS.

Hematopoietic stem cell (HSC) gene therapy using vectors that express various anti-HIV transgenes has also been attempted in clinical trials, but inefficient gene transfer in these studies has severely limited the potential of this approach.

The high marking levels allowed us to demonstrate protection from SHIV in lymphocytes derived from gene-modified macaque long-term repopulating cells that expressed an HIV-1 fusion inhibitor.

We observed a statistically significant 4-fold increase of gene-modified cells after challenge of lymphocytes from one macaque that received stem cells transduced with an anti-HIV vector (p<0.02, Student's t-test), but not in lymphocytes from a macaque that received a control vector.

We also established a competitive repopulation assay in a second macaque for preclinical testing of promising anti-HIV vectors.

The vectors we used were HIV-based and thus efficiently transduce human cells, and the transgenes we used target HIV-1 genes that are also in SHIV, so our findings can be rapidly translated to the clinic.

CONCLUSIONS: Here we demonstrate the ability to select protected HSC-derived lymphocytes in vivo in a clinically relevant nonhuman primate model of HIV/SHIV infection.

This approach can now be evaluated in human clinical trials in AIDSlymphoma patients.

In this patient setting, chemotherapy would not only kill malignant cells, but would also increase the number of MGMTP140K-expressing HIV-resistant cells.

This approach should allow for high levels of HIV-protected cells in AIDS patients to evaluate AIDS gene therapy.

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(PMID = 17651024.001).

[ISSN] 1087-2914

[Journal-full-title] AIDS patient care and STDs

[ISO-abbreviation] AIDS Patient Care STDS

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] United States

45. Levine AM: Management of AIDS-related lymphoma.Curr Opin Oncol; 2008 Sep;20(5):522-8[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Management of AIDS-relatedlymphoma.

PURPOSE OF REVIEW: With the advent of highly active antiretroviral therapy, the epidemiology of AIDS-lymphoma has changed, and prognosis has improved.

Although the incidence of AIDS-lymphoma has decreased, the incidence of HIV-associated Hodgkin's lymphoma has increased; mechanisms for these changes in epidemiology will be discussed.

RECENT FINDINGS: Use of highly active antiretroviral therapy, either concomitantly or immediately after completion of chemotherapy, has resulted in rates of complete remission and survival that are similar to those in HIV-negative patients.

The use of rituximab, while initially controversial because of reports of increased risk of infectious death, is associated with improved outcome; the increased risk of infectious death has not been confirmed.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Primary cardiac lymphomas are rare lesions in children with acquired immunodeficiency syndrome (AIDS).

Most of them are high-grade Burkitt's or Burkitt-like lymphomas.

The clinical profile and operative and pathological findings of a 4-year-old boy with AIDS-associated Burkitt's lymphoma of the heart presenting with acute right heart failure and fatal secondary pulmonary hypertension is reported.

[Number-of-references] 33

48. Valencia ME: AIDS-related lymphomas--potentially curable in the HAART era.AIDS Rev; 2006 Apr-Jun;8(2):108-10[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Accurately distinguishing between cerebral toxoplasmosis and primary central nervous system lymphoma (PCNSL), still the most common secondary CNS mass lesion complications of AIDS, has long represented a diagnostic challenge in those with HIV.

A young adult male with AIDS presented with evolving ophthalmoplegias, Parinaud's syndrome and gait dysfunction.

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(PMID = 21686485.001).

[ISSN] 1757-790X

[Journal-full-title] BMJ case reports

[ISO-abbreviation] BMJ Case Rep

[Language] eng

[Publication-type] Journal Article

[Publication-country] England

[Other-IDs] NLM/ PMC3027744

50. Dunleavy K, Wilson WH, Kaplan LD: The case for rituximab in AIDS-related lymphoma.Blood; 2006 Apr 1;107(7):3014-5[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Language] eng

[Publication-type] Comment; Letter

[Publication-country] United States

51. Hassan A, Kreisel F, Gardner L, Lewis JS Jr, El-Mofty SK: Plasmablastic lymphoma of head and neck: report of two new cases and correlation with c-myc and IgVH gene mutation status.Head Neck Pathol; 2007 Dec;1(2):150-5[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Plasmablastic lymphoma of head and neck: report of two new cases and correlation with c-myc and IgVH gene mutation status.

Plasmablastic lymphoma (PBL) is a rare acquired immunodeficiency syndrome-associated non-Hodgkin's lymphoma (AIDS-NHL), with predilection for the mucosa of oral cavity.

It usually has a plasmablastic morphology, expressing plasma cell-associated antigens with weak or absent expression of B-cell-associated markers.

To further define the immunophenotypic and molecular genetics of these tumors, we investigated two cases of plasmablastic lymphomas of the head and neck for c-myc gene rearrangement and immunoglobulin heavy chain (IgV(H)) hypermutation status.

For the first time we report a case of AIDS-related PBL that, by fluorescence in situ hybridization (FISH), shows a c-myc gene rearrangement.

Although current literature suggests that most cases of c-myc gene rearranged AIDS-NHL are Burkitt's lymphoma, our case has an immunophenotype characteristic for PBL.

The concurrent B-cell immunophenotype of BCL-6(-)/CD138(+)/MUM-1(+) also suggests a post-germinal center B-cell origin of this lymphoma.

But the true prevalence of HIVrelated neuroinfections and pathology is not available due to inadequate medical facilities, social stigma and ignorance that lead to underdiagnosis.

HIV encephalitis and HIV associated dementia are considered infrequent, though systematic studies have just been initiated in various centres.

Till now the AIDS cases in India were drug naive but a new cohort of cases following initiation of HAART therapy as a national policy is soon emerging, altering the biology and evolution of HIV/AIDS in India.

Lacunae in the epidemiology, diagnosis and study of biology of HIV/AIDS are outlined for future research.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

A retrospective study was conducted of extranodal oral Non-Hodgkin's Lymphomas diagnosed at the Surgical Pathology Laboratory of the School of Dentistry at Buenos Aires University, Argentina, between 1985 and 2004.

The most common histological type was Diffuse Large Cell Lymphoma.

60% of the Plasmablastic Lymphomas in the series came from HIV+ patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

It still needs to be clarified whether P-gp expression has a significant impact on non-Hodgkin's lymphoma treatment response, but a poor outcome has been reported in patients with positive P-gp expression.

AIDS-related lymphomas have aggressive behavior, and although a complete response could be achieved, relapse is not uncommon.

In an attempt to determine a possible relationship between MDR and poor outcome in this population, histologic samples obtained from 45 non-Hodgkin's lymphoma HIV-infected patients without previous cytotoxic therapy were submitted to immunohistochemical analysis using monoclonal antibody C494 specific for the MDR-1 isoform of P-gp.

In patients having achieved complete remission, the median disease-free survival (DFS) was not reached; the mean DFS was 57.2 months with DFS rates of 72.9% in three years.

Our results show that P-gp is expressed before treatment of non-Hodgkin's lymphoma of HIV patients, and is related to poor response to treatment and overall survival.

Multicentric Castleman's disease should always be kept in the differential diagnosis of HIV-positive patients suspected of having lymphoma to avoid misdiagnosis.

We report the case of a 40-year-old HIV-positive homosexual man who presented with lower back pain and features highly suggestive of lymphoma including lymphadenopathy, elevated lactic dehydrogenase, and splenomegaly.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] KSHV/HHV8-associatedlymphomas.

This review looks at the current state of knowledge on primary effusion lymphoma (PEL) and other Kaposi sarcoma herpesvirus (KSHV)/human herpesvirus 8 (HHV8)-associatedlymphomas.

In 1995, KSHV DNA sequences were identified within a distinct subgroup of acquired immunodeficiency syndrome-related non-Hodgkin lymphomas localized in body cavities and presenting as pleural, peritoneal and pericardial lymphomatous effusions.

Subsequently, the spectrum of KSHV/HHV8-associatedlymphomas has been expanded by the identification of cases of extracavitary solid lymphomas without serous effusions.

Despite the diversification in the clinical presentation of KSHV/HHV8-associatedlymphomas, the majority of the cases reported demonstrated similar morphology, immunophenotype and KSHV/HHV8 viral status.

KSHV/HHV8 infection is also in multicentric Castleman disease-associated plasmablastic lymphoma.

METHODS: Poisson regression models, with calendar periods to represent antiretroviral therapy, were extended to analyze first incident AIDS-defining cancers and other first AIDS-defining events as competing risks.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: Human immunodeficiency virus (HIV) infection is known to be associated with an increased risk of non-Hodgkin's lymphoma (NHL).

The majority of lymphomas (>80%) occurring during immunosuppression are aggressive B-cell in origin and have a high-to-intermediate histology grade.

OBJECTIVES: To assess the clinical effectiveness and safety of single agent or combination chemotherapy with or without immunochemotherapy (rituximab) and with or without highly active antiretroviral therapy (HAART) on overall survival (OS) and disease-free survival (DFS) for previously untreated patients with AIDS-related NHL.

For additional information see the Cochrane HIV/AIDS Group search strategy.

Disease free survival (DFS) was reported in two of the four RCTs, but it was not statistically significant between treatment groups.

AUTHORS' CONCLUSIONS: We found no evidence that the systemic interventions for untreated patients with AIDS-related NHL provide superior clinical effectiveness for improving OS, DSF, and tumour response rate; however, this conclusion is based on four RCTs with limited sample size and variable quality.

[Number-of-references] 112

60. Lather N, Islam M, Fergus IV: Symptomatic metastatic right atrial lymphoma in a patient with AIDS presenting with pulmonary embolization.Rev Cardiovasc Med; 2008;9(4):275-9[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Symptomatic metastatic right atrial lymphoma in a patient with AIDS presenting with pulmonary embolization.

Secondary lymphoma with localization to the heart is the third most common malignant heart tumor and is more common, by far, than primary cardiac lymphomas.

In patients with human immunodeficiency virus, the risk of development of systemic lymphoma is 60 to 200 times higher than in the general population.

Transthoracic echocardiography is the initial modality of choice for diagnosis of cardiac lymphomas because it is readily available and helps localize the tumor, but transesophageal echocardiography and magnetic resonance imaging remain the best tests for evaluation.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Plasmablastic lymphoma of the oral cavity is a form of non-Hodgkin lymphoma (NHL) and was first described in 1997.

We describe a case of plasmablastic lymphoma in an HIV-infected patient who presented with an expanding oral lesion and symptoms of a toothache.

We review all cases of plasmablastic lymphoma that have been reported in the literature.

Plasmablastic lymphoma is strongly associated with immunodeficiency, and most particularly, with HIV infection.

The pathophysiological origin of plasmablastic lymphoma has not been fully characterised, but the presence of Epstein-Barr virus (EBV) has often been documented in biopsy specimens, supporting a role for EBV in the pathogenesis of this lymphoma.

Infectious disease clinicians should be aware of this newly described and increasingly encountered lymphoma, since it is prominently associated with immunosuppression and may be mistaken for other entities.

In a prior report we demonstrated that this approach is well tolerated in patients with underlying immunodeficiency from HIV infection.

Furthermore, similar engraftment to the non-HIV setting and low infectious risks have been observed.

With long-term follow-up we demonstrate that ASCT can lead to an 85% progression-free survival, which suggests that this approach may be potentially curative in select patients with relapsed HIV-associated HD or NHL.

We report the first comparative analysis between HIV-Ly and a matched cohort of HIV(-) lymphoma patients.

This retrospective European Group for Blood and Marrow Transplantation study included 53 patients (66% non-Hodgkin and 34% Hodgkin lymphoma) within each cohort.

Both groups were comparable except for the higher proportion of males, mixed-cellularity Hodgkin lymphoma and patients receiving granulocyte colony-stimulating factor before engraftment and a smaller proportion receiving total body irradiation-based conditioning within the HIV-Ly cohort.

A higher nonrelapse mortality within the first year after ASCT was observed in the HIV-Ly group (8% vs 2%), predominantly because of early bacterial infections, although this was not statistically significant and did not influence survival.

Thus, within the highly active antiretroviral therapy era, HIV patients should be considered for ASCT according to the same criteria adopted for HIV(-) lymphoma patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: To elucidate the development of human immunodeficiency virus (HIV) clinical care and research in Hong Kong.

DATA SOURCES: Articles on clinical HIV and acquired immunodeficiency syndrome (AIDS) published from 1985 to 2004 were identified through four sources: Red Ribbon Centre, Special Preventive Programme, Secretariat of the Scientific Committee on AIDS, and PubMed search.

Prevalence of HIV has remained low in Hong Kong but new infections continue to occur together with a significant number of late presenters.

Three published AIDS patients' series, up to the first 200 reported cases, identified Pneumocystis carinii pneumonia as the most common AIDS-defining illness in Hong Kong.

Local studies of Kaposi's sarcoma and HIV-associated lymphoma have also been reported.

Research on CD4 counts has revealed that it is lower in healthy and HIV-infected Chinese than their western counterparts.

Children, pregnant women, and haemophiliac patients infected with HIV are among the specific groups of patients studied.

Survival of patients with advanced disease has greatly improved over the years, particularly after the advent of highly active antiretroviral therapy.

CONCLUSION: The clinical presentation and outcome of HIV/AIDS patients in Hong Kong are a mixture of those of western and developing countries.

Research on clinical HIV/AIDS in Hong Kong is not only beneficial to the planning of patient care, but also enables the formulation of treatment guidelines and provides a reference for other countries.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Plasmablastic lymphoma: a clinicopathologic correlation.

Plasmablastic lymphoma (PBL) is an uncommon, recently described B-cell-derived lymphoma that displays distinctive affinity for extranodal presentation in the oral cavity.

Plasmablastic lymphoma is strongly associated with human immunodeficiency virus (HIV) infection, but has been reported in HIV-negative individuals.

Plasmablastic lymphoma may be poorly recognized by pathologists, which is partly attributable to its relatively rare occurrence and unusual immunophenotype.

Five cases of oral cavity lymphomas conforming to the current World Health Organization morphological criteria for PBL were retrieved from the consultation files at the Armed Forces Institute of Pathology.

Follow-up revealed only 1 patient alive with no evidence of disease.

Our cases show that PBL is an aggressive type of B-cell lymphoma predominantly found in the oral cavity.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Non-Hodgkin's lymphoma is an AIDS-defining disease.

We collected data of 214 cases of AIDS-relatedLymphoma (ARL) treated at our centre from January 1984 until May 2003 and analysed them using the Kaplan-Meier-, log rank- and Cox proportional hazard-model.

The incidence of AIDS-related primary CNS lymphomas (PCNSL) took a comparable, yet more pronounced development.

Using the univariate Kaplan-Meier analysis prolonged survival was significantly associated with the achievement of a complete remission as well as with a favourable virological response to HAART.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PURPOSE OF REVIEW: AIDS-related malignancies are an ongoing cause of mortality in individuals with HIV infection.

In the HIV-negative setting, high-dose chemotherapy or stem cell transplantation is an option for patients with hematologic malignancies.

Prior to the advent of effective HIV therapy, stem cell transplantation was not feasible for HIV-positive patients.

The purpose of this article is to explore the transplant options for HIV-positive patients after widespread use of highly active antiretroviral therapy.

RECENT FINDINGS: Early autologous stem cell transplantation has studies had high relapse rates but they demonstrated that mobilization and engraftment of autologous stem cells were possible in AIDS patients.

The feasibility of allogeneic stem cell transplantation in HIV-infected individuals is less tested.

SUMMARY: The potential future applications of autologous and allogeneic stem cell transplantation are the cure of the malignancy as well as the underlying HIV infection by either transplantation of naturally resistant or genetically modified stem cells.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Treatment and prognosis of AIDS-relatedlymphoma in the era of highly active antiretroviral therapy: findings from the Swiss HIV Cohort Study.

OBJECTIVE: To assess the characteristics of combination antiretroviral therapy (cART) administered concomitantly with chemotherapy and to establish prognostic determinants of patients with AIDS-related non-Hodgkin's lymphoma.

METHODS: The study included 91 patients with AIDS-related non-Hodgkin's lymphoma from the Swiss HIV Cohort Study enrolled between January 1997 and October 2003, excluding lymphomas of the brain.

We extracted AIDS-related non-Hodgkin's lymphoma- and HIV-specific variables at the time of lymphoma diagnosis as well as treatment changes over time from charts and from the Swiss HIV Cohort Study database.

Thirty-five patients stopped chemotherapy prematurely (before the sixth cycle) usually due to disease progression; these patients had a shorter median survival than those who completed six or more cycles (14 versus 28 months).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

This is a mono-institutional analysis of the clinical features, immunological and virological findings, and prognostic factors of patients with HIV infection and HHV-8-lymphoproliferative disorders.

Patients with Multicentric Castleman Disease and HHV-8-relatedlymphoma diagnosed and treated from April 1987 to June 2004 were included in the study.

HHV-8 and HIV plasma viral load, CD4+ count, hematologic parameters, and general wellbeing (performance status) were assessed at the onset of the diseases and analyzed in order to identify possible prognostic factors.

Here we report four cases of KSHV-bearing solid lymphomas that occurred in AIDS patients (cases 1 to 3) and in a human immunodeficiency virus (HIV)-seronegative person (case 4).

Epstein-Barr virus was detected in two of the HIV-related cases.

All KSHV-positive solid lymphomas exhibited PEL-like cell morphology.

To investigate the relationship of these disorders to PEL and to other AIDS-associated diffuse large cell lymphomas, KSHV-positive solid lymphomas were tested for the expression of a set of genes that were previously shown by gene profiling analysis to define PEL tumor cells.

The results showed that expression of this set of genes in KSHV-positive lymphomas is similar to that of PEL but distinct from KSHV-negative AIDS-associated diffuse large cell lymphomas.

Because pathobiological features of KSHV-positive solid lymphomas closely mimic those of PEL, our results suggest that KSHV-positive solid lymphomas should be considered as a tissue-based variant of classical PEL, irrespective of HIV status.

RESULTS: PBMC-EBV levels in HIV-infected patients were higher than in the blood donors (p<0.05).

Similar PBMC-EBV loads were seen in HIV-infected patients with CD4+ T cell counts higher than 50/mm(3) (p>0.05), while significantly lower levels were found in cases with less than 50 cells/mm(3) (p<0.05).

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(PMID = 16931088.001).

[ISSN] 1201-9712

[Journal-full-title] International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

[ISO-abbreviation] Int. J. Infect. Dis.

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] Canada

76. Miles SA, McGratten M: Persistent panhypogammaglobulinemia after CHOP-rituximab for HIV-related lymphoma.J Clin Oncol; 2005 Jan 1;23(1):247-8[Fulltext service] Get downloadable fulltext PDFs of articles closely matching to this article, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

PURPOSE OF REVIEW: The success of combined antiretroviral therapy (cART) has transformed HIV infection into a survivable chronic disease in developed countries.

Increasingly then, the risks of HIV associated cancers become paramount.

RECENT FINDINGS: Recent conference proceedings appear to corroborate early reports that intensive therapy of HIV-Burkitt lymphoma is feasible and effective.

Moreover, as breakthroughs in the pathogenesis of lymphoma in general and Burkitt lymphoma in particular suggest that HIV infection plays a significant role, the opportunity for targeted therapy based on differences in biology are wholly untapped.

SUMMARY: Advances are being made in HIV-Burkitt lymphoma, but future studies need to incorporate our expanding understanding of biology to improve efficacy and reduce toxicity, preferably by integrating a biologic approach to this curable disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

According to the published data, most primary central nervous system lymphomas (PCNSLs) are B-cell lymphomas; primary T-cell lymphomas are rare.

Here, we present the case of a 43-year-old man with AIDS, not on highly active antiretroviral therapy, who presented with focal neurologic symptoms and was found on magnetic resonance imaging to have multiple brain lesions.

A biopsy showed T-cell lymphoma, and the patient was subsequently treated with whole-brain radiation, to marked clinical response.

Reported cases from the literature of primary T-cell PCNSL in AIDS patients are summarized in this review.

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(PMID = 17899696.001).

[ISSN] 0919-6544

[Journal-full-title] Neuropathology : official journal of the Japanese Society of Neuropathology

[ISO-abbreviation] Neuropathology

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Australia

81. Navarro JT, Lloveras N, Ribera JM, Oriol A, Mate JL, Feliu E: The prognosis of HIV-infected patients with diffuse large B-cell lymphoma treated with chemotherapy and highly active antiretroviral therapy is similar to that of HIV-negative patients receiving chemotherapy.Haematologica; 2005 May;90(5):704-6[Fulltext service] Download fulltext PDF of this article and others, as many as you want.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The prognosis of HIV-infected patients with diffuse large B-cell lymphoma treated with chemotherapy and highly active antiretroviral therapy is similar to that of HIV-negative patients receiving chemotherapy.

In the era of highly active antiretroviral treatment (HAART), the prognosis of AIDS-related lymphomas might be similar to that of aggressive B-cell lymphomas in human immunodeficiency (HIV)-negative patients.

In this study we found that HIV-infected patients with diffuse large B-cell lymphoma treated with cyclophosphamide, hydroxydoxorubicin, vincristine and prednisone (CHOP) and HAART showed a similar response rate to chemotherapy, disease-free survival and overall survival as those of HIV-negative patients receiving CHOP.

Zp-V3 was significantly associated with AIDS-PCNSL (P<0.001) and with systemic AIDS-NHL (P=0.007), in particular with AIDS-related immunoblastic lymphoma (P<0.001).

Moreover, in malignant samples, this variant was also significantly associated with type B EBV (P<0.001).

Finally, the new identified Zp-PV variant was isolated in 7 AIDS-PCNSL.

CONCLUSIONS: The frequency of polymorphisms in the regulatory zone of BZLF1 is different between malignant and non-malignant samples in AIDS patients and may identify EBV subtypes with different transforming activities, including those associated to the pathogenesis of B cell lymphoma.

Since the introduction of combination antiretroviral therapy (cART), there has been a decrease in the incidence of non-Hodgkin lymphoma among the HIV-infected population and also significantly improved survival rates.

We describe a remarkable case of a HIV-infected patient whose large B-cell lymphoma, most likely arising by transformation of a nodal marginal zone lymphoma, completely regressed with the use of cART alone.

He remained disease-free for almost 3 years and he finally died from presumed flare up of his lymphoma.

There are very few cases of spontaneous regression of lymphomas with cART alone in the HIV population.

This is an extreme example of the significance of cART in improving survival in HIV-non-Hodgkin lymphoma and changing the face of the HIV epidemic in general.

[Number-of-references] 31

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]HIV infection and lymphoma.

The incidence of lymphoma in patients with HIV infection greatly exceeds that of the general population.

The increased risk for lymphoma appears related to multiple factors, including the transforming properties of the retrovirus itself, the immunosuppression and cytokine dysregulation that results from the disease, and, most importantly, opportunistic infections with other lymphotrophic herpes viruses such as Epstein-Barr virus and human herpesvirus 8.

Histologically lymphomas fall into three groups:.

(2) those occurring more specifically in HIV-positive patients; and (3) those also occurring in patients with other forms of immunosuppression.